Mumbai public hospitals set pace for affordable kidney transplants

MUMBAI: City public hospitals are setting an example by conducting affordable kidney transplants when the programme is almost at a standstill in private hospitals.

Data collated by the state Directorate of Health Services (DHS) has revealed that 71% kidney transplants, performed in the city under the Rajiv Gandhi Jeevandayee Arogya Yojana (RGJAY) over the last four years, were carried out by public hospitals. Of 191 transplants covered under the scheme since its inception in July 2012, 136 took place at civic and state-run hospitals.

KEM Hospital in Parel topped the list with 92 transplants, despite a crushing patient load. It was followed by BYL Nair Hospital at Mumbai Central with 24 transplants; Sion and JJ carried out 15 and five transplants respectively in these years. The Government Medical College in Nagpur has done four transplants since it started the programme in 2015.

Among the private hospitals, SevenHills in Marol, Jogeshwari-based Mallika and Godrej Memorial Hospital, Vikhroli, are the only active participants. SevenHills has performed 31 surgeries, the highest for a private hospital, charging a little over Rs 39 lakh in three years. Mallika has performed 13 surgeries, while Godrej has carried out 11. All have done the surgeries at a cost of Rs 1.20-1.38 lakh.

Public health minister Dr Deepak Sawant called it “unfortunate” that most leading private hospitals in Mumbai, that run robust renal transplant programmes, have chosen to shun the government health scheme. “They can easily extend services to the poor by becoming part of the scheme but they are unwilling to accept our rates,” he told TOI. Under RGJAY, hospitals are paid Rs 1.5 lakh for a surgery, while most private hospitals charge at least three to six times that amount.

The state is miffed as it recent appeal to 20 top private hospitals in Mumbai, Pune and Nashik to join the scheme barely evoked a response. “Barring two, most did not show willingness. If more private hospitals join the scheme, it will drastically reduce the waiting time and burden on public hospitals,” said Dr Gauri Rathod, nodal officer for the Human Organs Transplant Act, DHS. RGJAY caters to families with an annual income of up to a lakh. Private hospitals carry out 300-350 kidney transplants in the city annually.

Private hospitals maintain that the amount allocated under the scheme barely covers the doctor’s fee, leave alone associated costs. The head of a leading private hospital in south Mumbai said the state needs to differentiate between trust-run and corporate hospitals. “Trust-run hospitals such as Breach Candy, Lilavati and Jaslok are serving the poor by reserving beds and allocating 2% of their gross billing in an indigent patient fund (IPF). It will be difficult to sustain if we were to become part of the state insurance scheme too,” said the head, adding that corporate hospitals should be told to share the burden of affordable patient care.

The insurance trend is quite opposite in other parts of the state, where private hospitals are outperforming their public counterparts. Out of 509 kidney transplants across Maharashtra under the scheme, 369 (72%) were done in private hospitals. Private hospitals in Aurangabad are doing most of the transplants.

With immense pride “India Live” celebrated its 10th national conference in Mumbai from 28th February to 3rd March 2019. The conference turned out to be a gold mine of information, with emphasis on academics, education and exchange of knowledge with leaders in interventional cardiology from both India and abroad.